摘要
目的分析凶险性前置胎盘产妇应用米非司酮联合Bakri宫腔球囊治疗的临床疗效。方法采用随机数表法将我院于2018年1月—2019年12月期间收治的86例凶险性前置胎盘产妇分为参照组和病例组,其中参照组43例,剖宫产术中单纯应用Bakri宫腔球囊治疗,病例组43例,剖宫产术中应用米非司酮联合Bakri宫腔球囊治疗,对比两组产妇止血效果、凝血指标、预后情况及新生儿预后情况。结果病例组产妇术中出血量、术后2 h出血量、术后24 h出血量较参照组更少,且产后出血率更低,数据差异有统计学意义(P<0.05);两组产妇治疗前TT、PT、APTT等凝血指标水平,差异无统计学意义(P>0.05),病例组产妇凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)等凝血指标水平较参照组更低,数据差异有统计学意义(P<0.05);病例组产妇子宫切除、弥散性血管内凝血、产褥病等不良预后发生率较参照组更低,数据差异有统计学意义(P<0.05);病例组新生儿Apgar评分较参照组更高,数据差异有统计学意义(P<0.05),两组新生儿呼吸窘迫、新生儿窒息发生率,差异无统计学意义(P>0.05)。结论凶险性前置胎盘产妇应用米非司酮联合Bakri宫腔球囊治疗可以减少术中出血,预后术后出血,且有助于改善凝血指标,减少产妇与新生儿不良预后的发生。
Objective To analyze the clinical effect of mifepristone combined with Bakri intrauterine balloon in the treatment of dangerous placenta previa.Method 86 pregnant women with dangerous placenta previa in our hospital from January 2018 to December 2019 were randomly divided into reference group and case group,of which 43 cases were treated with Bakri intrauterine balloon during cesarean section and 43 cases were treated with mifepristone combined with Bakri intrauterine balloon during cesarean section.The hemostatic effect,coagulation index,prognosis and neonatal prognosis of the two groups were compared.Results Compared with the reference group,the maternal blood loss during operation,2 hours after operation and 24 hours after operation in the case group was less,and the postpartum hemorrhage rate was lower,with statistical significance(P<0.05).There was no significant difference in TT,PT,APTT and other coagulation indexes between the two groups before treatment(P>0.05).The coagulation indexes of TT,PT and APTT in the case group were lower than those in the reference group,the difference was statistically significant(P<0.05).The incidence of adverse prognosis such as hysterectomy,disseminated intravascular coagulation and puerperal disease in the case group was lower than that in the reference group,and the data difference was statistically significant(P<0.05).The Apgar score of newborns in the case group was higher than that in the reference group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of neonatal respiratory distress and neonatal asphyxia between the two groups(P>0.05).Conclusion Mifepristone combined with Bakri uterine balloon can reduce intraoperative bleeding,prognosis postoperative bleeding,and help to improve blood coagulation index,reduce the incidence of adverse prognosis of parturient and newborn.
作者
梅进华
MEI Jinhua(Obstetrics Gynecology,Huanggang Maternal and Child Health Hospital,Huanggang Hubei 438000,China)
出处
《中国继续医学教育》
2021年第24期151-155,共5页
China Continuing Medical Education
